Elbow Arthritis Explained

Elbow Arthritis (Osteoarthritis) is not a common elbow injury. Elbow Arthritis occurs most often secondary to trauma such as a broken elbow. The initial trauma of the fracture changes the mechanics of the elbow joint and sets off a process of progressive elbow joint degeneration. Middle aged men with the history of an elbow fracture are most often affected by Elbow Arthritis. People who use power tools for prolonged periods are also predisposed to Elbow Arthritis. In order to fully understand Arthritis of the elbow, it is helpful to review the anatomy of the elbow joint.

The elbow is a hinged synovial joint between the upper arm (Humerus) and the forearm (Ulna and Radius). The widest bony points of the upper arm are just above the elbow joint and are called the Medial and Lateral Epicondyles. The outer part of the upper arm at the elbow joint is known as the Capitellum, which forms a joint with the head of the Radius. The inside of the upper arm at the elbow joint is known as the Trochlea, which forms a joint with the Trochlear notch of the Ulna. The Radius and Ulna also form a joint with each other known as the 'Proximal Radio-Ulna' joint.

Apart from the bending and straightening movements at the hinge of the elbow joint, the Proximal Radio-Ulna joint produces rotation of the Radius which is very important for movements of the wrist and hand. If any of the complicated joint surfaces of the elbow region become damaged by trauma or overuse then there is danger of developing Arthritis of the elbow joint.

Like all joints, the ends of the bones of the elbow joints are covered in Hyaline cartilage. The Hyaline cartilage is ultra smooth to allow friction free movement. However, early damage to the superficial layers produces a frayed appearance. In time, with more stress, this frayed surface evolves into cracks or 'fissures' in the Articular cartilage, which can leave the underlying bone exposed to the point that there is bone on bone contact.

With continued overuse of the elbow joint there are changes in the Hyaline cartilage and underlying bone, as well as the soft tissues that surround the elbow. As the joint becomes deformed by bony changes the ligaments which support the joint become stretched.

Elbow Arthritis Signs & Symptoms

Elbow pain is the most common symptom of Elbow Arthritis and can radiate down the forearm or up to the shoulder. There is often a grating noise that accompanies elbow joint movement, which is a result of a loss of the smooth Hyaline cartilage. As Elbow Arthritis progresses, loose pieces of cartilage or bone may get jammed in the elbow joint and cause a restriction of movement. Because the elbow joint is restricted, fluid can accumulate in the joint and cause pressure on the Ulnar Nerve. This causes pins and needles and tingling in the little finger and ring finger. The diagnosis of Elbow Arthritis is confirmed with an x-ray which is characterised by a loss of joint space between the two bones.

People with Elbow Arthritis often 'overdo it', either in sport or during work activities, and they will experience a flare up from the degenerate joint. This flare up may last for 48 hours and usually consists of stiffness (particularly in the morning) and pain in the affected joint. Flare ups will settle with rest and the use of NSAID's (Non Steroidal Anti Inflammatory Drugs) prescribed by a doctor. Ice therapy can also be helpful.
Ice Packs can be applied for periods of twenty minutes every couple of hours (never apply ice directly to the skin as it can cause an ice burn). The
Aircast CryoCuff is an excellent method of providing ice and compression to the elbow joint. It can provide up to six hours of continuous cold therapy to relieve pain and reduce inflammation within the tissue.

A substantial time period may pass before there is another flare up, but typically each flare up will get progressively more intense. The time interval between flare ups will decrease to the point where, eventually, the person will have pain even at rest. As the disease progresses the symptoms that start off being triggered by over activity, become triggered by immobility. Whereas, in the early stages, rest is essential during a flare up period, disuse in the later stages will exacerbate the problem.

In the later stages, if there is pain at rest and during the night, as well as problems with mobility, then elbow joint surgery may be appropriate. Elbow arthroscopy (key hole surgery) has developed greatly in the last few years. This technique allows loose fragments of bone and cartilage to be removed in order to restore normal elbow function. Elbow arthroscopy is much less invasive than conventional elbow joint replacement surgery and has been demonstrated to decrease pain and improve range of motion.

Elbow joint replacement takes place under a general anaesthetic. It involves an orthopaedic surgeon replacing the Humerus and Ulna joint surfaces of the elbow joint with a metal hinge. Elbow rehabilitation with a physiotherapist begins immediately and full elbow range of motion is usually achieved after 6 weeks.

Patient education is one of the most effective treatment strategies for Elbow Arthritis. By understanding the nature of Osteoarthritis the patient can make adjustments to their lifestyle that will make the problem more manageable. In summary, the patient must understand that too much activity or too little activity will make the problem worse. Each individual is different but, over time and through experience, each person will learn the optimum level of activity for their elbow joint.

During the early phase, flare ups are best treated symptomatically. NSAIDs prescribed by a doctor are effective in relieving pain.
Anti Inflammatory Gel can also help and doesn't have the side effects associated with Anti Inflammatory tablets. An
Ice Pack may be used to relieve a hot painful elbow joint.
Ice Packs can be applied for periods of twenty minutes every couple of hours (never apply ice directly to the skin as it can cause an ice burn). The
Aircast CryoCuff can be used to provide continuous ice and compression to the elbow joint. It can relieve pain and reduce inflammation within the tissue.

Many people find that wearing a
Neoprene Support can help provide support and reassurance. As Elbow Arthritis tends to be more painful during cold winter months, a Neoprene Support is often helpful as it provides soothing warmth to the joint.

Once Arthritis of the elbow has been formally diagnosed a more long term preventative strategy can be undertaken. This is aimed at reducing pain and stiffness and maintaining range of movement in the affected joint. A sensible approach can prevent excessive degeneration which may eventually lead to disability.

Each individual case is different and a full assessment by a Chartered Physiotherapist will identify factors that may exacerbate the problem. Where the elbow joint is affected maintenance of full range of motion is encouraged to reduce stiffness. Elbow movement can be lost if the person doesn't use the full range of motion because of pain. A physiotherapist can use manual techniques to help maintain the range of movement. Massage can help to relieve elbow pain and restore function.

Pain in the Elbow joint can lead to weakness in the forearm muscles. This can lead to a loss of grip strength. Exercises to maintain forearm muscle strength are encouraged to provide support for the affected joint. This strengthening should be done under the supervision of a physiotherapist.
Exercise Bands,
Grip Strengtheners,
Therapeutic Putty and
Hand Therapy Balls can all be used to maintain grip strength and dexterity.

Elbow Arthritis Prevention

Repetitive elbow movements and prolonged work with tools should be avoided, as should keeping the elbow in one position for a period of time. Frequent breaks should be taken to stretch and take the Elbow joint through its full range of motion, as the Hyaline cartilage draws most of its nourishment from the synovial fluid within the joint, and this has the effect of providing nutrients to the joint surfaces.

The Ultimate Performance Air Tennis Elbow Support offers all-day pain relief by targeting the tendons responsible for the bending and extending movements of the wrist joint. The soft neoprene blend will mould to the contours of the arm providing maximum support while helping to encourage the healing process. More Details

The PSB Arm Strap was developed using the latest fabrics and manufacturing techniques by a team of experienced technicians who worked closely with professional athletes to create a to a high quality band designed to alleviate the pain caused by prolonged gripping. More Details

BodyHelix have developed a high performance range of form fitting sleeves with distinctive state-of-the-art design to ensure a superior fit which conforms neatly to the contours of the body. More Details

The BodyHelix SuperStretch Elbow cuff has been designed to address a variety of common and painful elbow conditions. Quite often these injuries occur as a result of overuse or overexertion or because of direct impact, for example a fall. More Details

The GB Silver professional SuperStretch BodyHelix Elbow Helix sleeve is the chosen support of 1966 England World Cup Winning Goalkeeper Gordon Banks providing the ideal solution to everyday aches and pains. More Details

Latex Bands provide light, medium to heavy resistance during training exercises and are designed for increasing strengthening exercises during rehab and sports training. 99.99% free from latex allergens. More Details

The hand grip strengthener features a foam handle to ensure of a comfortable grip. The hand grip strengthener has durable foam handles and resistance springs to increase the strength of the forearm and the hand grip. More Details

This resistance exercise band pack features five boxes each of which has varying levels of resistance. Each latex band measures 5.5mx15cm and can be cut accordingly to suit your preference. Latex bands provide light, medium to heavy resistance during exercise and are specifically designed to increase strength during rehab and sports training. More Details

The Empi Direct TENS machine (transcutaneous electrical nerve stimulator) is a compact dual channel handheld device which utilises a range of nerve stimulation programmes to aid in the treatment and management of chronic and acute conditions. More Details

Ultimate Performance Cold Gel is a unique formula designed for the efficient relief of joint and muscle pain, this fast-acting gel is readily absorbed deep into the skin cooling the affected area and distracting the brain from the source of the problem. The anti-inflammatory and analgesic qualities of UP Cold Gel will provide all the associated benefits of a gentle muscle massage. More Details

Physicool is an innovative and uniquely designed reusable strapping that combines the healing characteristics of cold therapy with the support qualities of a compression bandage. Differing from the more traditional treatments currently available, Physicool works by drawing heat away from the body to provide an instant long-lasting cooling effect which can be utilised for extended periods. More Details

The Physicool combination pack supplies you with one specially formulated cooling bandage and one bottle of recharging coolant which will rejuvenate and refresh the dressing. Small and compact this kit is ideal for wrist, elbow and ankle injuries providing between 2-3 hours of cold therapy and compression. More Details

Physicool is a new and unique way to instantly apply cold therapy whilst on the move, this portable and reusable compression bandage is applied quickly and easily allowing the healing process to begin immediately. By taking heat away from the body Pysicool have developed a product which differs from move traditional methods meaning it can be used for longer periods. More Details

The Donjoy X-Act ROM Elbow Brace is a lightweight open-design support which has been created for post-injury and post-surgery rehabilitation. This telescopic product is easily altered to provide a unique tailored fit while padded lined malleable aluminium cuffs can be moulded to the contours of the anatomy improving usability and comfort throughout recovery. More Details

Ultimate Performance Sports Balm can be used to provide quick and effective pain relief, ease joint discomfort and help relieve muscle soreness with its unique blend of herbal ingredients and natural oils which combine to produce a gentle warming effect. More Details

Ultimate Performance Extra Strong Sports Balm can be used to provide quick and effective pain relief, ease joint discomfort and help relieve muscle soreness. The unique blend of essential oils initially cool the skin before gently warming the area with the added benefit of the soothing cinnamon aroma. More Details

Following on from the huge success of Dynamint Muscle Balm, the company have now released a brand new handy sized muscle and joint spray dispenser offering a more convenient way to ease those aches and pains. More Details

From Dynamint the next in a generation of pain reducing muscle and joint applicators, the new 'Roll-On'. This conveniently sized applicator follows on from the huge success of the muscle balm and joint spray products to provide a 'no fuss, no mess' alternative to ease away the discomfort of daily life or sports-based activities. More Details

Easy to use dual channel digital TENS machine for effective pain relief featuring seven preset programmes. Just stick on the electrodes, press a button and this simple-to-use TENS machine will use an electrical current to reduce your pain. More Details

IMPORTANT SAFETY NOTICE

The articles on this web site are provided for general information only and should not be used as a basis for diagnosis or treatment. All exercises and information featured on this web site should only be practised under the supervision of a qualified healthcare professional.